以皮肤病为首发症状内脏恶性肿瘤临床分析.docVIP

以皮肤病为首发症状内脏恶性肿瘤临床分析 　　[摘要] 目的 了解皮肤病合并恶性肿瘤的临床特点，以便早期发现内脏恶性肿瘤。 方法 对本院2006～2013年收治的14例以皮肤病为首发症状的内脏恶性肿瘤患者进行回顾性分析。 结果 14例患者中男12例，女2例，以皮肤转移癌为首发症状的有6例，其中4例皮肤表现为肤色结节或肿块，2例表现为溃疡；以副肿瘤性皮肤病发病者有6例，其中皮肌炎3例，红皮病2例，恶性黑棘皮病1例；另外2例发生带状疱疹。 结论 认识肿瘤的皮肤表现，将有助于早期发现内脏肿瘤。 　　[关键词] 皮肤病；内脏肿瘤；首发症状 　　[中图分类号] R73 [文献标识码] B [文章编号] 1673-9701（2013）32-0131-03 　　Clinical analysis of visceral malignant tumors whose first symptom was skin disease 　　ZHENG Yunyan1 WU Changping2 YANG Yuhua1 　　1.Department of Dermatology，the Third Affiliated Hospital of Suzhou University， Changzhou 213003， China；2. Department of Oncology， the Third Affiliated Hospital of Suzhou University， Changzhou 213003， China. 　　[Abstract] Objective To understand the clinical features of skin diseases associated with visceral malignant tumors for early detection of malignant tumor. Methods Fourteen cases with viscera malignant tumors whose first symptom was skin disease，hospitalized in our hospital from 2006 to 2013， were analyzed retrospectively. Results The fourteen patients were consisted of 12 males and 2 females. Six cases presented with skin metastasis as the first symptom， four of them displayed skin nodules or masses， other two showed ulcers. Paraneoplastic dermatosis as first symptoms occurred in other six cases， including three cases with dermatomyositis， two erythroderma and one malignant acanthosis nigrican. In addition， there were two cases manifested with herpes zoster. Conclusion Recognizing the skin manifestations that served as first symptom of tumors， will contribute to the early discovery of visceral tumors 　　[Key words] Skin disease；Visceral tumors；First symptom 　　内脏恶性肿瘤的皮肤表现，根据病理生理学特点，可分为肿瘤的直接效应和间接效应。肿瘤的皮肤转移为直接效应，是指恶性肿瘤转移灶生长影响周围器官或组织的正常功能；副肿瘤性皮肤病是间接效应，是指恶性肿瘤或其转移灶经复杂生物学效应，影响远处器官或组织的正常功能[1]。部分恶性肿瘤以皮肤表现为首发症状，所以认识内脏肿瘤的皮肤表现具有重要性，而且皮肤体格检查具有直观性、无创性，为潜在的内脏恶性肿瘤提供诊断线索。现对本院2006年～2013年中14例以皮肤病为首发症状的内脏肿瘤患者进行回顾性临床分析。 　　1 临床资料 　　1.1 皮肤转移性恶性肿瘤 　　以皮肤结节、肿块或溃疡首诊，通过病理检查确定是皮肤转移癌患者共有6例。6例患者均为男性，年龄37～79岁，皮疹出现到就诊时间3个月～1年，原发肿瘤及皮肤